S Achenbach1, W Moshage, K Bachmann. 1. Department of Internal Medicine II, University of Erlangen-Nürnberg, Erlangen, Germany. stephan.achenbach@stud.uni-erlangen.de
Abstract
BACKGROUND: Contrast-enhanced electron beam computed tomography (EBCT) has been shown to permit noninvasive visualization of the coronary arteries. We determined the value of EBCT to noninvasively detect high-grade restenosis after percutaneous transluminal coronary angioplasty (PTCA). METHODS AND RESULTS: Fifty patients (37 to 68 years of age), were investigated by EBCT at a mean interval of 9 months after PTCA of coronary artery stenoses. Forty axial cross-sections of the heart (3-mm slice thickness, 1-mm overlap) were acquired triggered to the ECG after intravenous injection of contrast agent. Three-dimensional reconstructions of the coronary arteries were rendered with a lower threshold of 80 HU to selectively visualize the contrast-enhanced vessel lumen. EBCT results were compared with conventional quantitative coronary angiography (QCA) performed within 1 week. In 6 patients, the PTCA segment could not be evaluated because of impaired image quality. Sixteen of the remaining 44 patients had high-grade restenoses in QCA (>70% diameter reduction), which was correctly detected by EBCT in 15 cases (94% sensitivity). There were 5 false-positive EBCT results of high-grade restenosis (82% specificity). CONCLUSIONS: EBCT with intravenous injection of contrast agent permits the noninvasive diagnosis of restenosis after PTCA, with high sensitivity and sufficient specificity.
BACKGROUND: Contrast-enhanced electron beam computed tomography (EBCT) has been shown to permit noninvasive visualization of the coronary arteries. We determined the value of EBCT to noninvasively detect high-grade restenosis after percutaneous transluminal coronary angioplasty (PTCA). METHODS AND RESULTS: Fifty patients (37 to 68 years of age), were investigated by EBCT at a mean interval of 9 months after PTCA of coronary artery stenoses. Forty axial cross-sections of the heart (3-mm slice thickness, 1-mm overlap) were acquired triggered to the ECG after intravenous injection of contrast agent. Three-dimensional reconstructions of the coronary arteries were rendered with a lower threshold of 80 HU to selectively visualize the contrast-enhanced vessel lumen. EBCT results were compared with conventional quantitative coronary angiography (QCA) performed within 1 week. In 6 patients, the PTCA segment could not be evaluated because of impaired image quality. Sixteen of the remaining 44 patients had high-grade restenoses in QCA (>70% diameter reduction), which was correctly detected by EBCT in 15 cases (94% sensitivity). There were 5 false-positive EBCT results of high-grade restenosis (82% specificity). CONCLUSIONS: EBCT with intravenous injection of contrast agent permits the noninvasive diagnosis of restenosis after PTCA, with high sensitivity and sufficient specificity.
Authors: Birgit Hailer; Peter Van Leeuwen; Illja Chaikovsky; Sabine Auth-Eisernitz; Harald Schäfer; Dietrich Grönemeyer Journal: Ann Noninvasive Electrocardiol Date: 2005-04 Impact factor: 1.468
Authors: T C Gerber; P F Sheedy; M R Bell; D L Hayes; J A Rumberger; T Behrenbeck; D R Holmes; R S Schwartz Journal: Int J Cardiovasc Imaging Date: 2001-02 Impact factor: 2.357